Male Pattern Baldness (Androgenic Alopecia)

What is male pattern baldness?

Male pattern baldness (androgenic alopecia) is a type of hair loss that affects people assigned male at birth (AMAB). It causes you to lose hair on the skin covering your head (scalp), and your hair doesn’t grow back. Other signs of male-pattern baldness include thinning hair and a hairline that moves farther back on your head (receding hairline).

There are seven stages of male pattern baldness according to the Hamilton-Norwood scale:

• Stage 1: There’s little or no hair loss or hairline recession.
• Stage 2: There’s slight hair loss near the skin between your ears and forehead (temples).
• Stage 3: You have deep hairline recession around your temples, and your hairline may have an “M” or “U” shape.
• Stage 4: You have very deep hairline recession and a loss of hair at the top of your head (crown).
• Stage 5: Your hairline recession connects to the bald spot on your crown.
• Stage 6: The hair between your temples and crown is thinning or gone.
• Stage 7: You have no hair on the top of your head and a thin band of hair around the side of your head.

Who does male pattern baldness affect?

Male pattern baldness can affect anyone assigned male at birth.

However, male pattern baldness affects people differently based on their ethnic heritage. You’re more likely to have male pattern baldness if you’re white, followed by Afro-Caribbean. You’re less likely to experience male pattern baldness if you’re of Chinese or Japanese descent. Male pattern baldness doesn’t typically affect Native American, First Nations and Alaska Native peoples.

You’re more likely to have male pattern baldness if you have a family history of it. If your grandfather, father or brothers have male pattern baldness, your odds of having it are higher.

Does male pattern baldness run on my mother’s side of the family?

If your mother’s father (maternal grandfather) has male pattern baldness, there’s a good chance that you’ll have male pattern baldness as well. However, there may be a link between male pattern baldness and your father. If your father is bald, you’re twice as likely to have male pattern baldness.

How common is male pattern baldness?

Male pattern baldness affects two-thirds of all people assigned male at birth, and your odds of experiencing some hair loss increase with age.

How does male pattern baldness affect my body?

Male pattern baldness causes the small depressions in your scalp at the base of your hairs (hair follicles) to gradually shrink, often in a specific pattern. As your hair follicles shrink, your individual hairs get thinner and shorter. Over time, those hairs stop growing at all.

Male pattern baldness doesn’t affect your physical health. However, it can affect you psychosocially (how society and social groups affect your thoughts and emotions) and psychologically (how you think about yourself and your behavior). You may experience emotional stress, anxiety and depression.

What are the symptoms of male pattern baldness?

Symptoms of male pattern baldness include:

• Hair thinning or loss on your crown.
• Hair thinning or loss near your temples.
• Receding hairline.

Male pattern baldness doesn’t hurt. Many start to notice the early stages of male pattern baldness by their 30s, but they may begin as early as your late teenage years or early 20s.

Hair loss on your crown usually appears in a circular shape. A receding hairline often occurs in an “M” shape. As you continue to lose hair, hair loss around your crown and temples may meet to form a “U” shape.

What causes male pattern baldness?

The following factors contribute to male pattern baldness:

• Age: The chances of developing male pattern baldness increase with age. About 25% of people assigned male at birth see the first signs of hair loss before age 21. By age 50, half experience hair loss, and about 70% will lose hair as they get older.
• Hormones: Dihydrotestosterone (DHT) is a type of androgen. Androgens are a group of sex hormones that help people enter puberty and mature physically. Physical developments include hair growth on the face, scalp, chest, underarms and genitals. Medical experts and researchers think that there might be a link between DHT and your hair follicles shrinking.
• Genetics: People assigned male at birth have one X chromosome they inherit from their mother and one Y chromosome they inherit from their father. The AR gene on your X chromosome tells your body how to make androgens. Your AR gene’s sensitivity helps determine male pattern baldness.

Is male pattern baldness contagious?

No, male pattern baldness isn’t contagious.

How is male pattern baldness diagnosed?

Male pattern baldness is easy to recognize, so you don’t necessarily need a healthcare provider to diagnose it. However, your healthcare provider can confirm it during a physical exam of your scalp. They’ll ask you about your medical history, including when you started noticing hair loss and whether you have a family history of male pattern baldness. They’ll note the shape of your hairline and any areas showing signs of thinning or balding.

What tests will be done to diagnose male pattern baldness?

Your healthcare provider may use a special tool called a densitometer to examine your scalp. A densitometer measures the thickness of your hair follicles.

If your healthcare provider suspects your hair loss isn’t related to male pattern baldness, they may:

• Examine your scalp for signs of infection.
• Take a sample of your hair and send it to a lab for analysis.
• Take a scalp biopsy to check for skin disease.
• Conduct blood tests.

What medications/treatments are used to treat male pattern baldness?

Hair loss treatments include:

• Medications: Over-the-counter (OTC) medications you apply to your scalp, such as minoxidil (Rogaine®), are usually the first course of treatment for male pattern baldness. Some side effects of minoxidil may include headache, scalp irritation and unusual hair growth. A prescription oral medication, such as finasteride (Propecia®), can also treat male pattern baldness. Some side effects may include allergic reactions, testicular pain and erectile dysfunction.
• Hair transplant: A healthcare provider takes skin grafts from areas of your body that contain healthy hair and moves them to bald or thinning areas of your scalp. Side effects may include scalp pain and irritation, scarring, dizziness, nausea and vomiting.
• Platelet-rich plasma: A healthcare provider removes blood from your body, processes it and injects it into your scalp to stimulate hair growth. Side effects may include scalp pain and irritation, dizziness, nausea and vomiting.
• Styling techniques: You may hide your male pattern baldness with certain hairstyles, wigs or hair weaves.

How soon after treatment will I feel better?

Minoxidil may take two to four months of daily use before you notice any improvement in your hair loss. Finasteride may take at least three months of daily use before you notice any improvement. If you stop using either medication, your regrown hair will fall out.

A hair transplant usually takes at least three weeks to recover. It may take up to a year before you see the full results. You may need several “touch-up” hair transplant surgeries to achieve a natural-looking result.

Platelet-rich plasma injections usually take at least three weeks to recover. You may need more injections to maintain your results.

How can I prevent male pattern baldness?

Medical researchers and healthcare providers don’t know of any way to prevent male pattern baldness. However, there are ways to help keep your hair healthy that may promote hair growth, including:

• Eating extra protein, especially if you’re vegetarian or vegan. You need 40 to 60 grams (g) of protein a day. The Mediterranean diet includes fruits, vegetables and protein that may help minimize hair loss.
• Taking vitamins. Certain vitamins and minerals — including vitamins A, B, C, D, E, zinc and iron — help maintain healthy hair, skin and muscle tissue.
• Finding ways to cope with stress. Stress may contribute to male pattern baldness by increasing activity in your androgens.

What can I expect if I have male pattern baldness?

Many people with male pattern baldness think it’s part of the aging process and are comfortable with how it looks. However, your healthcare provider can help slow or replace your hair loss.

When should I see my healthcare provider?

Many people choose not to see a healthcare provider if they have male pattern baldness. However, if you’d like to maintain your hair, you should call your healthcare provider as soon as you notice hair loss on your scalp.

What questions should I ask my healthcare provider?

• How can you tell that I have male pattern baldness?
• If I don’t have male pattern baldness, what’s causing my hair to fall out?
• What medications or treatments do you recommend?
• What’s the complete list of side effects for the medications and treatments?
• What else can I do to prevent further hair loss?
• Should I see a dermatologist or plastic surgeon?

What’s the difference between telogen effluvium and male pattern baldness?

Telogen effluvium is a type of hair loss that involves rapid shedding of hair over a short period. It typically happens a few months after your body goes through something physically or emotionally stressful. It can also result from sudden hormonal changes. Hair loss due to telogen effluvium is usually temporary, and your hair often grows back without treatment once you no longer have stress.

Male pattern baldness is a type of hair loss that’s more gradual than telogen effluvium. It’s not known exactly what causes male pattern baldness. Without medications or treatment, hair loss due to male pattern baldness is permanent.

A note from Cleveland Clinic

Male pattern baldness is a common condition that affects most people assigned male at birth as they age. Many people that have male pattern baldness accept it as part of the aging process and don’t see a healthcare provider. However, it can negatively affect your mental health. Reach out to your healthcare provider as soon as you notice signs of male pattern baldness, especially if it causes stress, anxiety or depression. Medications and treatments are available that can stop or reverse it.